POS1080 CHARACTERIZATION OF JOINT DISTRIBUTION AND DISEASE BURDEN IN PATIENTS WITH EARLY OLIGOARTICULAR PSORIATIC ARTHRITIS: RESULTS FROM THE ONGOING FOREMOST STUDY
Authors: D. D. Gladman, L. Coates, L. Gossec, J. Aelion, J. Vasandani, S. Cheng, L. Tang, S. Jardon, S. Richter, P. J. Mease
Journal: Annals of the Rheumatic Diseases (2022)

Background Oligoarticular psoriatic arthritis (PsA) is commonly reported in early disease. Although fewer joints are involved, there may be significant impact on patients’ (pts) quality of life. The ongoing FOREMOST study ( NCT03747939 ) is investigating the efficacy of apremilast vs placebo for treatment of early oligoarticular PsA (&gt;1 but ≤4 tender and swollen joints involved). Objectives To characterize disease burden in pts with early oligoarticular PsA and disease phenotype including location and size of involved joints and presence of certain baseline clinical PsA manifestations in FOREMOST pts. Methods Baseline swollen and tender joint distribution was analyzed. Baseline disease burden was assessed in the overall group and a subgroup with small joint involvement only (for context) using clinical disease activity measures, pt-reported outcomes, and additional PsA manifestations. Results At data cut-off for analysis, 220 pts of 285 planned were enrolled. In the overall group, disease duration was &lt;1 year and joint distribution for swollen or tender joints involved predominantly small joints, with ~48% of joint involvement observed in finger proximal interphalangeal (PIP) joints and &lt;2% in temporomandibular and clavicular joints across swollen or tender joints (Figure 1). Mean Physician’s and Patient Global Assessment of Disease Activity (PhGA and PtGA, respectively) scores were 43.9 and 51.3; mean pt pain assessment score was 50.7. Mean Health Assessment Questionnaire Disability Index (HAQ-DI) functional assessment score was 1.0; 25.5% of pts had HAQ-DI ≤0.5. Pts reported an average PsA Impact of Disease (PsAID-12) domain score of 4.7. Additional manifestations of PsA at baseline included dactylitis (14.5%), enthesitis (32.7%), nail involvement (67.3%), and skin disease (47.7% with body surface area [BSA] ≥3%). Within the overall group, 59% had &gt;1 joint size involved (small [metacarpophalangeal, metatarsophalangeal, distal interphalangeal, PIP, hand carpometacarpal and mid-tarsal]; intermediate [wrist, elbow, ankle, temporomandibular, acromioclavicular, sternoclavicular]; large [shoulder, hip, knee]). Of those with only 1 joint size involved (41% of pts), the majority had small joint involvement predominantly in PIPs (n=84 for small joints; n=1 for intermediate joints; n=5 for large joints). The overall pattern of clinical and disease presentation indicated elevated burden for pts with early oligoarticular PsA, including those pts with only small joints involved (Table 1). Table 1. Characteristics Overall Population (PBO + APR), N=220 Small Joints Only (PBO + APR), N=84 Age, mean, y 49.6 51.3 Men, n (%) 98 (44.5) 40 (47.6) Europe/Russia, n (%) 47 (21.4)/66 (30.0) 22 (26.2)/11 (13.1) Canada/United States, n (%) 8 (3.6)/99 (45.0) 1 (1.2)/50 (59.5) Body mass index, mean, kg/m 2 30.4 29.3 Duration of disease, mean, y 0.69 0.71 Previous cDMARD use, n (%) 143 (65.0) 48 (57.0) Tender joint count (0–68), mean 3.2 3.1 Swollen joint count (0–66), mean 2.6 2.8 PhGA (VAS 0–100) a , mean 43.9 39.0 PtGA (VAS 0–100) a , mean 51.3 45.6 Patient’s Assessment of Pain (VAS 0–100) a , mean 50.7 46.3 Dactylitis present, n (%) 32 (14.5) 14 (16.7) Enthesitis present, n (%) 72 (32.7) 21 (25.0) BSA ≥3%, n (%) 105 (47.7) 34 (40.5) Nail involvement present, n (%) 148 (67.3) 53 (63.1) HAQ-DI (0–3) a , mean 1.02 0.84 HAQ-DI ≤0.5, n (%) 56 (25.5) 31 (36.9) PsAID-12 (0–10) a , mean 4.73 3.98 cDMARD, conventional disease-modifying antirheumatic drugs; VAS, visual analog scale. a Higher scores indicate greater burden/worse status. Early oligoarticular = ≤2 years in the initial protocol; ≤5 years in the current protocol for inclusion. Figure 1. FOREMOST population: baseline demographics and disease burden in the overall population and pts with involvement in small joints only Conclusion In FOREMOST, despite few joints involved, pts with early oligoarticular PsA experienced high disease burden and impaired quality of life. Small joint involvement, although less commonly expected in oligoarticular PsA, was the most frequently observed pattern. Acknowledgements The authors thank the patients, their families, and all investigators involved in this study. This study was funded by Amgen Inc. Writing support was funded by Amgen Inc. and provided by Kristin Carlin, BSPharm, MBA, of Peloton Advantage, LLC, an OPEN Health company, and Cathryn M. Carter, MS, employee of and stockholder in Amgen Inc. Disclosure of Interests Dafna D Gladman Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, and UCB – grant/research support or consulting fees, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, and UCB – grant/research support or consulting fees, Laura Coates Speakers bureau: AbbVie, Amgen, Biogen, Bristol Myers Squibb, Celgene Corporation, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Medac, Moonlake, Novartis, Pfizer, and UCB –grant/research support, consulting fees, and/or speaker/honoraria, Consultant of: AbbVie, Amgen, Biogen, Bristol Myers Squibb, Celgene Corporation, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Medac, Moonlake, Novartis, Pfizer, and UCB –grant/research support, consulting fees, and/or speaker/honoraria, Grant/research support from: AbbVie, Amgen, Biogen, Bristol Myers Squibb, Celgene Corporation, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Medac, Moonlake, Novartis, Pfizer, and UCB –grant/research support, consulting fees, and/or speaker/honoraria, Laure Gossec Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene Corporation, Galapagos, Gilead, GSK, Janssen, Lilly, Novartis, Pfizer, Samsung Bioepis, Sanofi-Aventis, and UCB, Grant/research support from: Amgen, Galapagos, Lilly, Pfizer, and Sandoz, Jacob Aelion Grant/research support from: AbbVie, Celgene, Eli Lilly and Regeneron – speakers bureau. AbbVie, Ardea Biosciences, AstraZeneca, Bristol Myers Squibb, Celgene, Centocor, Eli Lilly, Galapagos, Genentech, GlaxoSmithKline, Human Genome Sciences, Janssen, Merck, Mesoblast, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi-Aventis, Takeda, UCB, and Vertex, Jitendra Vasandani: None declared, Sue Cheng Shareholder of: Stock ownership in Amgen Inc., Employee of: Employment by Amgen Inc., Lihua Tang Shareholder of: Stock ownership in Amgen Inc., Employee of: Employment by Amgen Inc., Shauna Jardon Shareholder of: Stock ownership in Amgen Inc., Employee of: Employment by Amgen Inc., Sven Richter Shareholder of: Stock ownership in Amgen at time of study, Employee of: Employment by Amgen at time of study., Philip J Mease Speakers bureau: AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, Sun, and UCB – grant/research support and consultant; Boehringer Ingelheim and GlaxoSmithKline – consultant, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, Sun, and UCB